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Patient education: Facial fractures (The Basics)

Patient education: Facial fractures (The Basics)

What are facial fractures? — A fracture is another word for a broken bone. When a person has a facial fracture, they have broken 1 or more bones in their face (figure 1).

Facial fractures can happen when a person is hit hard in the face. Common causes of facial fractures include sports injuries, car or bike accidents, and falls. Violence, like being hit in the face by another person, can also cause fractures.

There are different kinds of facial fractures, depending on which bone is involved and how it breaks. Some fractures are more serious than others. A fracture is called "displaced" if the bone is pushed out of its normal position. "Non-displaced" means the bone has a break or crack but stays in place.

Facial fractures can lead to other problems. For example:

If a muscle or nerve is injured, this can affect a person's ability to move or feel part of their face

Depending on where the fracture is, it might affect a person's breathing, seeing, speaking, or hearing

If a person has a serious head injury in addition to their facial fracture, this can lead to other serious problems. These problems can include brain damage, bleeding in the brain, infection, or seizures.

What are the symptoms of a facial fracture? — Symptoms can be mild or severe, depending on where the fracture is, how serious it is, and whether the person also has a head injury. Possible symptoms can include:

Pain, bruising, or swelling – Sometimes, it takes a day for swelling to start.

Changes to how the face looks – For example, the nose or jaw might be crooked or the eyes might not line up.

Headache

Feeling very tired, confused, or dizzy

Bleeding from the nose or ear

Clear fluid draining from the nose or ear – This is spinal fluid, the fluid that surrounds the brain and spinal cord.

Vomiting

Trouble smelling, hearing, or seeing

Weakness or numbness of the face

Is there a test for a facial fracture? — Yes. The doctor will ask about your symptoms and injury, and do an exam. To look for a fracture, they can do a CT scan of your face. This is an imaging test that creates pictures of the bones in the face and skull.

Depending on the type of injury, the doctor might also do X-rays or other imaging tests. The tests you get will also depend on whether you might have other problems like a head injury.

How are facial fractures treated? — It depends. If you have a small fracture and the bones have stayed in place, it might be able to heal on its own without treatment.

For people with severe fractures or other problems, treatment depends on the type of fracture and where it is. This might require staying in the hospital. For example:

Fractures around the eye – If the bone around the eye is fractured, the doctor will check the eyeball for injury. They will also check the person's vision and how well they can move their eyes. If there is serious injury, a doctor might need to do a procedure to relieve pressure in the eye. Surgery might also be needed.

Fractures around the nose – If the injury pushed the nose bones out of position, the bones will need to be put back where they belong. Doctors can sometimes do this using their hands or special tools. If this doesn't work, the bones can be put back into place with surgery.

Fractures of the cheek bone – Fractures in this area are often displaced, meaning the bones are out of position. This usually requires surgery to fix, to keep the normal shape of the face.

Fractures around the mouth or of the jaw bone – If any of the teeth fell out or are loose, a doctor or dentist will need to fix this. Sometimes, teeth can be put back into place. If the person cannot open their mouth normally, a procedure or surgery might be needed to put the jaw back into the correct position. In some cases, the person will need to eat only soft foods while the fracture heals. With more serious fractures, the jaw might need to be held closed (with special elastic or wire) for a few weeks in order to heal.

If the person has cuts or open wounds on the face, they might get antibiotics or vaccines to prevent infection.

When should I call the doctor or nurse? — After the person with the fracture goes home, call the doctor or nurse if they have:

Nausea or vomiting

A headache that won't go away

Fever

Take the person to the emergency department right away if they:

Have a sudden, severe headache

Have a seizure

Have trouble walking, talking, or seeing

Have weakness or numbness in their body

Aren't acting like themselves

Have blood or fluid leaking from the nose or ear

Pass out

What can I do to help prevent facial fractures? — To help prevent facial fractures, you should:

Wear safety gear, such as a helmet, goggles, or a face mask, when you play certain sports

Wear a helmet when you ride a bike or motorcycle

Wear a seat belt every time you drive or ride in a car

More on this topic

Patient education: Head injury in children and teens (The Basics)
Patient education: Skull fractures (The Basics)
Patient education: Nose fracture (The Basics)
Patient education: Concussion in adults (The Basics)
Patient education: Going home from the hospital (The Basics)
Patient education: Meningitis in children (The Basics)
Patient education: Vertigo (a type of dizziness) (The Basics)
Patient education: Seizures (The Basics)
Patient education: Head injury in adults (The Basics)
Patient education: Concussion in children and teens (The Basics)
Patient education: Tracheostomy (The Basics)
Patient education: Full liquid diet (The Basics)

This topic retrieved from UpToDate on: Jun 02, 2024.
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